BACKGROUND: There is considerable interest in oxygen partial pressure (Po2) monitoring in physiology, and in tracking Po2 changes dynamically when it varies rapidly. For example, arterial Po2 ([Formula: see text]) can vary within the respiratory cycle in cyclical atelectasis (CA), where [Formula: see text] is thought to increase and decrease during inspiration and expiration, respectively. A sensor that detects these [Formula: see text] oscillations could become a useful diagnostic tool of CA during acute respiratory distress syndrome (ARDS). METHODS: We developed a fibreoptic Po2 sensor (<200 µm diameter), suitable for human use, that has a fast response time, and can measure Po2 continuously in blood. By altering the inspired fraction of oxygen ([Formula: see text]) from 21 to 100% in four healthy animal models, we determined the linearity of the sensor's signal over a wide range of [Formula: see text] values in vivo. We also hypothesized that the sensor could measure rapid intra-breath [Formula: see text] oscillations in a large animal model of ARDS. RESULTS: In the healthy animal models, [Formula: see text] responses to changes in [Formula: see text] were in agreement with conventional intermittent blood-gas analysis (n=39) for a wide range of [Formula: see text] values, from 10 to 73 kPa. In the animal lavage model of CA, the sensor detected [Formula: see text] oscillations, also at clinically relevant [Formula: see text] levels close to 9 kPa. CONCLUSIONS: We conclude that these fibreoptic [Formula: see text] sensors have the potential to become a diagnostic tool for CA in ARDS.

Biomedical Centre Charles University Prague Faculty of Medicine in Pilsen alej Svobody 80 304 60 Pilsen Czech Republic 1st Medical Department Charles University Prague Faculty of Medicine in Pilsen alej Svobody 80 304 60 Pilsen Czech Republic

Nuffield Department of Clinical Neurosciences Nuffield Division of Anaesthetics University of Oxford Oxford UK

School of Veterinary Sciences University of Bristol Bristol UK

Zobrazit více v PubMed

Bergman NA. Cyclic variations in blood oxygenation with the respiratory cycle. Anesthesiology. 1961;22:900–8. PubMed

Folgering H, Smolders FDJ, Kreuzer F. Respiratory oscillations of the arterial PO2 and their effects on the ventilatory controlling system in the cat. Pflugers Arch. 1978;375:1–7. PubMed

Purves MJ. Fluctuations of arterial oxygen tension which have the same period as respiration. Respir Physiol. 1966;1:281–96. PubMed

Purves MJ. Communications. J Physiol. 1965;176:7–8P.

Albert RK. The role of ventilation-induced surfactant dysfunction and atelectasis in causing acute respiratory distress syndrome. Am J Respir Crit Care Med. 2012;185:702–8. PubMed

Baumgardner JE, Markstaller K, Pfeiffer B, Doebrich M, Otto CM. Effects of respiratory rate, plateau pressure, and positive end-expiratory pressure on PaO2 oscillations after saline lavage. Am J Respir Crit Care Med. 2002;166:1556–62. PubMed

Williams EM, Viale JP, Hamilton RM, McPeak H, Sutton L, Hahn CE. Within-breath arterial PO2 oscillations in an experimental model of acute respiratory distress syndrome. Br J Anaesth. 2000;85:456–9. PubMed

Hedenstierna G, Frostell C. Animal models for the study of pulmonary edema. In: Hoosier JHaGLV., editor. Handbook of Laboratory Animal Science. Boca Raton, FL: CRC Press; 2004. pp. 289–300.

Hedenstierna G, Nyman G, Frostell C. Animal models of lung physiology during anesthesia. In: Hoosier JHaGLV., editor. Handbook of Laboratory Animal Science. Boca Raton, FL: CRC Press; 2004. pp. 263–87.

Bodenstein M, Wang H, Boehme S, et al. Observation of ventilation-induced Spo2 oscillations in pigs: first step to noninvasive detection of cyclic recruitment of atelectasis? Exp Lung Res. 2010;36:270–6. PubMed

Klein KU, Hartmann EK, Boehme S, et al. PaO2 oscillations caused by cyclic alveolar recruitment can be monitored in pig buccal mucosa microcirculation. Acta Anaesthesiol Scand. 2013;57:320–5. PubMed

Shi C, Boehme S, Hartmann EK, Markstaller K. Novel technologies to detect atelectotrauma in the injured lung. Exp Lung Res. 2011;37:18–25. PubMed

Pfeiffer B, Syring RS, Markstaller K, Otto CM, Baumgardner JE. The implications of arterial Po2 oscillations for conventional arterial blood gas analysis. Anesth Analg. 2006;102:1758–64. PubMed

Yasbin RE, Matthews CR, Clarke MJ. Mutagenic and toxic effects of ruthenium. Chem Biol Interact. 1980;31:355–65. PubMed

Baumgardner JE, Otto CM, Markstaller K. Large changes in PaO2 oscillation amplitude with respiratory rate are not measurement artifact. Respir Physiol Neurobiol. 2014;195:59. PubMed

Formenti F, Farmery AD, Hahn CE. Response to Baumgardner et al. Respir Physiol Neurobiol. 2014;196C:38. PubMed

Formenti F, Chen R, McPeak H, Matejovic M, Farmery AD, Hahn CE. A fibre optic oxygen sensor that detects rapid PO2 changes under simulated conditions of cyclical atelectasis in vitro. Respir Physiol Neurobiol. 2014;191:1–8. PubMed PMC

Chen R, Farmery AD, Obeid A, Hahn CEW. A cylindrical-core fiber-optic oxygen sensor based on fluorescence quenching of a platinum complex immobilized in a polymer matrix. IEEE Sensors J. 2012;12:71–5.

Chen R, Formenti F, Obeid A, Hahn CE, Farmery AD. A fibre-optic oxygen sensor for monitoring human breathing. Physiol Meas. 2013;34:N71–81. PubMed

Saied A, Edgington L, Gale L, et al. Design of a test system for fast time response fibre optic oxygen sensors. Physiol Meas. 2010;31:N25–33. PubMed

Syring RS, Otto CM, Spivack RE, Markstaller K, Baumgardner JE. Maintenance of end-expiratory recruitment with increased respiratory rate after saline-lavage lung injury. J Appl Physiol. 2007;102:331–9. PubMed

Hartmann EK, Boehme S, Bentley A, et al. Influence of respiratory rate and end-expiratory pressure variation on cyclic alveolar recruitment in an experimental lung injury model. Crit Care. 2012;16:R8. PubMed PMC

Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10. PubMed

Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res. 1999;8:135–60. PubMed

Altman DG, Bland JM. Measurement in medicine—the analysis of method comparison studies. Statistician. 1983;32:307–17.

Herweling A, Karmrodt J, Stepniak A, et al. A novel technique to follow fast PaO2 variations during experimental CPR. Resuscitation. 2005;65:71–8. PubMed

Klein KU, Boehme S, Hartmann EK, et al. Transmission of arterial oxygen partial pressure oscillations to the cerebral microcirculation in a porcine model of acute lung injury caused by cyclic recruitment and derecruitment. Br J Anaesth. 2013;110:266–73. PubMed

Borges JB, Costa EL, Suarez-Sipmann F, et al. Early inflammation mainly affects normally and poorly aerated lung in experimental ventilator-induced lung injury. Crit Care Med. 2014;42:e279–87. PubMed

Derosa S, Borges JB, Segelsjo M, et al. Reabsorption atelectasis in a porcine model of ARDS: regional and temporal effects of airway closure, oxygen, and distending pressure. J Appl Physiol (1985) 2013;115:1464–73. PubMed

Markstaller K, Eberle B, Kauczor HU, et al. Temporal dynamics of lung aeration determined by dynamic CT in a porcine model of ARDS. Br J Anaesth. 2001;87:459–68. PubMed

Markstaller K, Kauczor HU, Weiler N, et al. Lung density distribution in dynamic CT correlates with oxygenation in ventilated pigs with lavage ARDS. Br J Anaesth. 2003;91:699–708. PubMed